Gingrich: Attack ACA Bit by Bit

by David Pittman David Pittman Washington Correspondent, MedPage Today
January 22, 2013

WASHINGTON -- Congressional Republicans should abandon an all-or-nothing approach and examine smaller aspects of the Affordable Care Act (ACA) to change or repeal, according to former Speaker of the House of Representatives Newt Gingrich.

Lawmakers who want to repeal President Obama's signature health reform law would have better results if they go after the least effective and most disruptive aspects of the law, Gingrich told reporters after meeting with the Congressional Health Care Caucus -- a group of House Republicans interested in healthcare issues -- for more than an hour here Tuesday morning.

"One of the problems that Health and Human Services and Secretary [Kathleen] Sebelius are having is they can't get their hands around it," Gingrich said of the ACA. "It's so complicated, so big that they can't implement it."

The Republican-controlled House of Representatives voted 31 times to repeal the ACA in the last 2 years -- a measure that never passed the Senate. With Democrats retaining control of the Senate and Obama winning re-election, chances of repeal remain slim.

But the law commonly called "Obamacare" nonetheless remains flawed, Gingrich said. For one thing, the law -- some of which is being implemented by the Centers for Medicare and Medicaid Services (CMS) -- creates more red tape for practicing physicians.

"If you elect the doctor to be more focused on the patient and you'd like the doctor's office to cost less," then what's needed is less paper technology, Gingrich said. "You wouldn't run any private business with the level of paper that CMS still uses."

The former Speaker has been vocal on a number of health issues since leaving Congress in 1999. In 2003, he founded the Center for Health Transformation, a healthcare think tank, which filed for bankruptcy last spring. In 2006, he authored the book "Saving Lives & Saving Money."

Rep. Mike Burgess, MD, (R-Texas) said the Obama administration may be its own worst enemy with the ACA because of its slow progress in unveiling rules on key issues such as setting up health insurance exchanges.

"That's an enormous undertaking, and I for one do not think that the federal agency is up to that task," said Burgess, who is chair of the Congressional Health Care Caucus.

The ob/gyn deferred on offering a solid opinion on whether Congress should consider delaying the federal subsidies for purchasing health insurance through an ACA exchange -- an option some have argued could save the country money.

"There have to be hearings on this and you've got to get the information first," Burgess said.

Gingrich also suggested lawmakers hold hearings on mental health in the broader debate about gun control and blamed "the deinstitutionalization of mental health" for missing those at risk to themselves and others.

On the issue of violence, tighter gun control laws may not reduce shooting deaths, the former speaker said, pointing to Illinois, a state with a number of gun control laws and still a high number of deaths.

"To what degree are panaceas of more regulations for the honest and the law-abiding -- but not the criminals -- in fact destructive? " Gingrich said.

To help better identify people with mental health issues, Gingrich said his "personal hunch is you're almost certainly going to see a modification of HIPAA [the Health Insurance Portability and Accountability Act]."

Gingrich, who was speaker when Congress passed the law, noted that "HIPAA has made it far too difficult to surface potentially dangerous people."

"I don't think we have a correct diagnosis about the challenges that are out there for individuals with mental illness who can potentially became a harm to society," Rep. Tom Price, MD (R-Ga.), told reporters Monday. "We don't have enough information in Congress to recommend the correct course of action."

The new Congress also would do well to examine reforms to the FDA and CMS, the former speaker said. Healthcare is on the cusp of a number of medical breakthroughs in regenerative medicine, brain science, cancer, and other areas that the health-related regulators aren't prepared to handle.

"Both the Food and Drug Administration bureaucracy and the CMS bureaucracy retard the development of regenerative medicine," Gingrich said.

These medical breakthroughs are "things we would have thought were a miracle 15 or 20 years ago, but the government bureaucracy's understanding of the science is way behind what's actually happening in the laboratory," Gingrich said.

Lastly, Gingrich suggested the new Congress should work on finding ways to reduce healthcare fraud.

"I hope that this will be the year that we surface waste and that we surface fraud and we surface those things that aren't working because that's a key part," Gingrich said. "You can't talk about controlling government spending and not look at 18% to 20% of the economy," which is roughly the percentage that he said healthcare fraud accounts for.

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